Anti-pooling vest for patients undergoing hemodialysis and in critical care

Abstract

An anti-pooling vest to be worn by a patient undergoing a hemodialysis procedure is disclosed for inhibiting intradialytic hypotensive symptoms in the patient during the course of hemodialysis treatment. The anti-pooling vest includes an inflatable bladder for applying a compressive pressure on the internal organs within the abdomen of the patient during the hemodialysis procedure to reduce the pooling of blood within the patient's internal organs. A pump, such as, for example, a manually compressible bulb or an electrically powered pump, in fluid communication with the bladder is operable to inflate the bladder to a predetermined pressure and a pressure relief valve in fluid communication with the bladder is operable to decrease the pressure within the bladder to the predetermined pressure. The anti-pooling vest may also be utilized to increase venous return in hypotensive patients in critical care suffering from blood or fluid loss by applying compressive pressure to the internal organs within the abdomen of the patient to reduce the pooling of blood within the patient's internal organs.

1. A method of inhibiting intradialytic hypotensive symptoms in a patient undergoing a hemodialysis procedure, comprising:
 elastically constraining the abdomen of the patient throughout the hemodialysis procedure while concurrently maintaining mobility of the patient's legs; and applying non-pulsating, gradually increasing compressive pressure to the internal organs within the abdomen of the patient according to a predefined protocol during the hemodialysis procedure, thereby reducing the pooling of blood within the patient's abdominal internal organs while concurrently allowing for unencumbered movement of the patient's legs during the hemodialysis procedure. 
 
     
     
       2. The method according to  claim 1 , wherein the protocol comprises adjusting the compressive pressure to a predetermined pressure associated with a time elapsed during the hemodialysis procedure. 
     
     
       3. The method according to  claim 2 , wherein the adjusting the compressive pressure comprises:
 adjusting the compressive pressure to a first predetermined pressure at the time when the hemodialysis procedure is initiated; and 
 adjusting the compressive pressure to a second predetermined pressure after a predetermined time interval has elapsed during the hemodialysis procedure. 
 
     
     
       4. The method according to  claim 3 , wherein the second predetermined pressure is greater than the first predetermined pressure. 
     
     
       5. The method according to  claim 4 , further comprising adjusting the compressive pressure to a third predetermined pressure after a second predetermined time interval has elapsed during the hemodialysis procedure. 
     
     
       6. The method according to  claim 5 , wherein the third predetermined pressure is greater than the second predetermined pressure. 
     
     
       7. The method according to  claim 6 , wherein the third predetermined pressure is a maximum compressive pressure to be applied to the patient's abdominal internal organs. 
     
     
       8. The method according to  claim 7 , wherein the maximum compressive pressure does not exceed about 30 mm Hg. 
     
     
       9. The method according to  claim 7 , wherein the maximum compressive pressure does not exceed about 20 mm Hg. 
     
     
       10. The method according to  claim 7 , wherein the maximum compressive pressure does not exceed 15 mm Hg. 
     
     
       11. The method according to  claim 3 , further comprising gradually reducing the compressive pressure for a predetermined time interval after completion of the hemodialysis procedure. 
     
     
       12. The method according to  claim 2 , wherein the compressive pressure is applied to the patient's internal organs by inflating a bladder elastically constrained about the patient's abdomen. 
     
     
       13. The method according to  claim 12 , wherein the compressive pressure is adjusted by inflating the bladder with a manually operated pump. 
     
     
       14. The method according to  claim 12 , wherein the compressive pressure is adjusted by deflating the bladder. 
     
     
       15. The method according to  claim 12 , wherein the compressive pressure is automatically adjusted by a pump controlled by a controller. 
     
     
       16. The method according to  claim 12 , further wherein the protocol comprises:
 measuring the actual pressure within the bladder; 
 activating the pump to increase the pressure within the bladder when the measured pressure is below the predetermined value; and 
 activating a relief valve to decrease the pressure within the bladder when the measured pressure is above the predetermined value. 
 
     
     
       17. An anti-pooling vest to be worn by a patient undergoing a hemodialysis procedure of a specified duration in order to inhibit intradialytic hypotensive symptoms in the patient during the procedure, comprising:
 an elastic bladder support within the vest configured to constrain the abdomen of the patient, while concurrently allowing the patient unencumbered and unconstrained leg movement, for the duration of the hemodialysis procedure; 
 an inflatable bladder supported by the bladder support that will apply a non-pulsating compressive pressure on the internal organs within the abdomen of the patient when the vest is worn during the hemodialysis procedure to thereby reduce the pooling of blood within the patient's internal abdominal organs; 
 a pump in fluid communication with the bladder and operable to gradually inflate the bladder to a predetermined pressure during the hemodialysis procedure; and 
 a pressure relief valve in fluid communication with the bladder through which pressure can be gradually released. 
 
     
     
       18. The anti-pooling vest according to  claim 17 , wherein the pump is a manually compressible bulb. 
     
     
       19. The anti-pooling vest according to  claim 17 , wherein the pump is electrically powered. 
     
     
       20. The anti-pooling vest according to  claim 17 , further comprising a pressure sensor for measuring the pressure within the bladder, wherein the pump is activated to increase the pressure within the bladder when the measured pressure is below the predetermined pressure, and the relief valve is activated to decrease the pressure in the bladder when the measured pressure is above the predetermined pressure. 
     
     
       21. The anti-pooling vest according to  claim 20 , wherein the predetermined pressure is based on the time elapsed during the hemodialysis procedure. 
     
     
       22. The anti-pooling vest according to  claim 20 , wherein the elastic bladder support comprises a flexible band having a proximal end, a distal end, an inner surface and an outer surface, the band including a pocket for receiving the inflatable bladder, wherein the band is adapted to wrap about the abdomen of the patient so that the bladder covers the patient's abdominal internal organs. 
     
     
       23. The anti-pooling vest according to  claim 17 , further comprising at least one fastener affixed to the proximal end of the band for releasably connecting to a corresponding fastener affixed to the distal end of the band when the band is wrapped about the abdomen of the patient. 
     
     
       24. The anti-pooling vest according to  claim 23 , wherein the at least one fastener is a Velcro-type fastener containing a plurality of hooks and the corresponding fastener is a Velcro-type fastener containing a plurality of loops. 
     
     
       25. The anti-pooling vest according to  claim 23 , further comprising an elastic strap having a first end and a second end, the first end affixed to the outer surface of the band and the second end having a fastener affixed thereto for releasably connecting to a corresponding fastener affixed to the outer surface of the band, wherein the second end of the strap may be stretched and releasably connected to the outer surface of the band to conform the band to the contour of the patient's abdomen after the band is wrapped about the abdomen of the patient. 
     
     
       26. The anti-pooling vest according to  claim 25 , wherein the fastener affixed to the second end of the elastic strip is a Velcro-type fastener containing a plurality of hooks and the corresponding fastener affixed to the outer surface of the band is a Velcro-type fastener containing a plurality of loops. 
     
     
       27. The anti-pooling vest according to  claim 23 , further comprising a plurality of elastic straps, each strap having a first end and a second end, the first end affixed to the outer surface of the band and the second end having a fastener affixed thereto for releasably connecting to a corresponding fastener affixed to the outer surface of the band, wherein the second end of each strap may be stretched and releasably connected to the outer surface of the band to conform the band to the contour of the patient's abdomen after the band is wrapped about the abdomen of the patient. 
     
     
       28. The anti-pooling vest according to  claim 27 , wherein the second end of at least one of the elastic straps extends and may be stretched in a direction toward the proximal end of the band, and the second end of at least one of the elastic straps extends and may be stretched in a direction toward the distal end of the band. 
     
     
       29. The anti-pooling vest according to  claim 17 , further comprising means for adjusting the pressure within the bladder to the predetermined pressure. 
     
     
       30. The anti-pooling vest according to  claim 29 , wherein the predetermined pressure corresponds to a desired pressure at a particular time during the hemodialysis procedure. 
     
     
       31. The anti-pooling vest according to  claim 30 , wherein the pressure in the bladder is increased to a maximum desired pressure during the hemodialysis procedure and gradually reduced for a predetermined time following the completion of the hemodialysis procedure. 
     
     
       32. The anti-pooling vest according to  claim 31 , wherein the maximum desired pressure does not exceed 30 mm Hg. 
     
     
       33. The anti-pooling vest according to  claim 31 , wherein the maximum desired pressure does not exceed 20 mm Hg. 
     
     
       34. The anti-pooling vest according to  claim 31 , wherein the maximum desired pressure does not exceed 15 mm Hg. 
     
     
       35. The anti-pooling vest according to  claim 31 , further comprising:
 means for selecting the length of the hemodialysis procedure; and 
 means for selecting the maximum desired pressure; 
 wherein the predetermined pressure at any given time during the procedure is determined based on the selected length of the hemodialysis procedure and the selected maximum desired pressure. 
 
     
     
       36. A system for inhibiting intradialytic hypotensive symptoms in a patient undergoing a hemodialysis procedure, comprising:
 an inflatable bladder adapted to be worn by the patient which is configured so that it will constrain the abdomen of the patient when worn, without concurrently constraining the limbs of the patient, while applying a non-pulsating, gradually increasing compressive pressure on the internal organs within the abdomen of the patient according to a predefined time-pressure protocol during a substantial portion of the hemodialysis procedure to thereby reduce the pooling of blood within the patient's internal organs while the hemodialysis procedure is occurring; 
 a pump in fluid communication with the bladder and operable to inflate the bladder to a predetermined pressure corresponding to a desired pressure at a particular time during the hemodialysis procedure; 
 a pressure relief valve in fluid communication with the bladder and operable to assist with regulation of the pressure within the bladder to about the predetermined pressure; and 
 a pressure sensor for measuring the pressure within the inflatable bladder, wherein the pump is activated to increase the pressure within the bladder when the pressure measured using the pressure sensor is below the predetermined pressure, and the relief valve is activated to decrease the pressure in the bladder when the pressure measured using the pressure sensor is above the predetermined pressure. 
 
     
     
       37. The system according to  claim 36 , wherein the pump is a manually compressible bulb. 
     
     
       38. The system according to  claim 36 , wherein the pump is electrically powered. 
     
     
       39. The system according to  claim 36 , further comprising a processor executing commands stored in a memory device, the processor:
 determining the predetermined pressure for a given time during the hemodialysis procedure based on a pressurization/depressurization protocol stored in the memory device; 
 comparing the predetermined pressure to the measured pressure; 
 activating the pump to increase the pressure within the bladder when the measured pressure is below the predetermined pressure; and 
 activating the relief valve to decrease the pressure in the bladder when the measured pressure is above the predetermined pressure. 
 
     
     
       40. The system according to  claim 39 , further comprising:
 means for selecting a length of the hemodialysis procedure; and 
 means for selecting a maximum desired pressure to inflate the bladder; 
 wherein the pressurization/depressurization protocol corresponds to the selected length of the hemodialysis procedure and the selected maximum desired pressure. 
 
     
     
       41. The system according to  claim 36 , wherein the pressure in the bladder is increased to a maximum desired pressure during the hemodialysis procedure and gradually reduced for a predetermined time following the completion of the hemodialysis procedure. 
     
     
       42. The system according to  claim 41 , wherein the maximum desired pressure does not exceed 30 mm Hg. 
     
     
       43. The system according to  claim 41 , wherein the maximum desired pressure does not exceed 20 mm Hg. 
     
     
       44. The system according to  claim 41 , wherein the maximum desired pressure does not exceed 15 mm Hg.